Factors Associated with Behavioral Competence at School Among Young Boys from Multi-Problem Low-Income Families

Factors associated with school behavioral competence at 72 months were investigated in a sample of at-risk boys followed longitudinally from 18 months. Boys were at risk for developing behavior problems due to early exposure to sociodemographic and family-environmental stressors associated with low-income urban living. Research findings: Of child protective factors investigated, main effects were found for intelligence, mother-reported emotionality and sociability, and observed likability in relation to teacher-reported behavior problems, and results were generally consistent across type of risk. In only one instance did the effect of a protective factor depend on the level of risk. Furthermore, a cumulative measure of protective factors was strongly predictive of child behavior problems and was a better predictor than cumulative risk measures. Observed infant emotionality, child physical attractiveness, and children's self-perceptions of being pro-social or aggressive and fearless were essentially unrelated to behavioral outcome. Mother-reported child emotionality mediated both the relation between mother-reported infant emotionality and teacher-reported internalizing problems, and the relation between observed likability and teacher-reported externalizing problems. Practice/Policy: Clinical implications concern improved identification accuracy of at-risk children who should be targeted for intervention, and forms that intervention should take.     

Factors Associated with Behavioral Competence at School Among Young Boys from Multi-Problem Low-Income Families

Factors associated with school behavioral competence at 72 months were investigated in a sample of at-risk boys followed longitudinally from 18 months. Boys were at risk for developing behavior problems due to early exposure to sociodemographic and family-environmental stressors associated with low-income urban living. Research findings: Of child protective factors investigated, main effects were found for intelligence, mother-reported emotionality and sociability, and observed likability in relation to teacher-reported behavior problems, and results were generally consistent across type of risk. In only one instance did the effect of a protective factor depend on the level of risk. Furthermore, a cumulative measure of protective factors was strongly predictive of child behavior problems and was a better predictor than cumulative risk measures. Observed infant emotionality, child physical attractiveness, and children's self-perceptions of being pro-social or aggressive and fearless were essentially unrelated to behavioral outcome. Mother-reported child emotionality mediated both the relation between mother-reported infant emotionality and teacher-reported internalizing problems, and the relation between observed likability and teacher-reported externalizing problems. Practice/Policy: Clinical implications concern improved identification accuracy of at-risk children who should be targeted for intervention, and forms that intervention should take.     

Service needs of adolescent parents in child welfare: Is an evidence-based,structured, in-home behavioral parent training protocol effective?

SafeCare is an evidence-based behavioral parent training intervention that has been successfully implemented in multiple state child welfare systems. A statewide implementation in Oklahoma established the effectiveness of SafeCare with a diverse group of parents, which included adolescent parents under 21 years of age, a particularly at-risk group. The current study examined whether SafeCare is also effective for this subsample of 294 adolescent parents with regard to child welfare recidivism, depression and child abuse potential, and attainment of service goals. Post-treatment adolescent parent ratings of program engagement and satisfaction were also examined. Among the subsample of adolescent parents, the SafeCare intervention did not result in significantly improved outcomes in terms of preventing recidivism or reduction in risk factors associated with child abuse and neglect as compared to child welfare services as usual. Further, no significant differences in program engagement and satisfaction between SafeCare and services as usual were detected. These findings shed light on the potential differences in program effectiveness between adolescent and adult parents, and the need for future research to rigorously evaluate the effectiveness of behavioral parenting programs with adolescent parents.     

Cumulative stress and substantiated maltreatment: the importance of caregiver vulnerability and adult partner violence

OBJECTIVE: Our goal is to assess the effect of caregiver vulnerabilities, singly and in combination, on the substantiation of child abuse (physical, sexual) and neglect, while controlling for relevant background variables. We test the moderator role of adult partner violence in qualifying the relationship between caregiver vulnerabilities and maltreatment substantiation. METHOD: Secondary analyses of the 1998 Canadian Incidence Study of Reported Child Maltreatment (CIS) are used to predict child protective service investigation substantiation versus non-substantiation from a range of caregiver vulnerability factors. Involvement in partner violence was examined as a moderator in the relation between caregiver vulnerabilities and maltreatment substantiation. The CIS is an epidemiological survey of first-reported cases to child protective services, using a random sample of child welfare agencies across Canada. Child welfare workers completed a research form on the child, primary caregiver, family, perpetrator, severity and type of maltreatment, as well as services and court outcomes. All maltreatment classifications were assigned according to the Canadian legal definition of child abuse and neglect. Hierarchical logistic regression analyses were used, with stepped entry of: (1) demographic factors, socioeconomic disadvantage, and caregiver's own history of maltreatment; (2) caregiver vulnerability factors; (3) involvement in partner violence; (4) the interaction between caregiver vulnerability and partner violence. RESULTS: Caregiver substance abuse was found to be the single most potent kind of caregiver vulnerability in predicting maltreatment substantiation. When the total number of vulnerabilities was used as the predictor, prediction across all types of maltreatment increased, especially for substantiated neglect. Analyses also showed that the presence of partner violence in the home exacerbated the effect of caregiver vulnerability on substantiation. CONCLUSIONS: The total number of caregiver vulnerabilities was the best predictor of the substantiation of child abuse and neglect. This relationship was moderated by the existence of partner violence: high caregiver vulnerability and high partner violence increased the likelihood of substantiation versus non-substantiation. These results suggest that caregiver issues should be considered in tandem with partner relationships. Among child welfare cases, caregiver vulnerability and partner violence are critical targets for child maltreatment prevention and early child protective services intervention.     

Educational neglect: Understanding 20 years of child welfare trends

Educational neglect is an understudied phenomenon that is difficult to define and also to address. While it is clear that attending to children’s academic needs is important to child development, few studies focus on educational neglect and therefore little is known about its associated risk factors and the outcomes following this form of maltreatment. The purpose of this research was to (a) determine the rate at which child welfare service providers investigate educational neglect in Canada and identify any trends in rates over time, (b) better understand educational neglect and its distinction from other types of neglect and truancy, and (c) understand how child welfare services respond to allegations of educational neglect. Data from five cycles of the Ontario Incidence Studies of Reported Child Abuse and Neglect were examined. A trend analysis was conducted followed by a mixed-method examination of educational neglect investigations. Results indicate that rates of investigated educational neglect in Ontario have been consistently low over time. However, these investigations are significantly more likely to be substantiated and to be transferred to ongoing child welfare services compared to investigations of other subtypes of neglect. Educational neglect investigations involving younger children are more likely to note risk factors for caregivers whereas those involving adolescents are more likely to note functioning issues for youth. The findings are discussed in relation to international trends in educational neglect and policy and practice implications are explored.     

Survivors of institutional abuse in long-term child care in Scotland

BackgroundThe Scottish Child Abuse Inquiry (SCAI) commissioned the research project to document the outcomes of institutional abuse in long-term child care in Scotland.ObjectiveTo profile the experiences of survivors abused in long-term child care in Scotland, and to develop a model which linked maltreatment, risk and protective factors, and outcomes.Participants and Setting225 survivors of historical institutional abuse in Scotland, who made witness statements to SCAI.MethodsData were extracted from witness statements using a coding frame developed through a thematic analysis of a subsample of 52 statements.ResultsSurvivors had been in care in predominantly Catholic and non-religious residential institutions in Scotland for an average of 8 years, having entered at an average age of 6.8 years. They had suffered multiple forms of maltreatment. Maltreatment rates were: physical abuse, 95.6%; emotional abuse, 85.3%; sexual abuse, 60.4%; emotional neglect, 51.1%; and physical neglect, 37.3%. Across the lifespan survivors had negative outcomes in psychosocial adjustment (96%), mental health (84%), and physical health (43%). The effect of maltreatment in care on psychosocial problems was mediated by both risk and protective factors; and on mental health was mediated by risk factors, but not protective factors. Maltreatment in care had a direct effect on physical health which was not mediated by risk or protective factors. The effects of the cumulative number of risk factors on adverse mental health and psychosocial outcomes was greater than that of maltreatment, and protective factors had a limited impact on adverse outcomes.ConclusionsEvidence-based child protection policies and practices should be implemented to prevent institutional abuse and treat child abuse survivors in Scotland.     

Risk factors for child physical abuse and neglect among Chinese young mothers

Although studies have reported a linkage between young pregnancy and child maltreatment risk, it is still unclear about what factors place young mothers at greater risk of maltreating their child in Chinese context. Based on the socio-ecological model, risk factors in 4 domains: family background/structure, maternal stressors, mother-child interaction, and child behavioral issue in relation to physical assault, neglect, both physical assault and neglect, and either physical assault or neglect among Chinese young mothers in Hong Kong were assessed. 392 young mothers were recruited from an integrated supportive program for young mothers. The mean age of mothers at delivery was 21.8 (SD = 3.0) and 52.3% were married. Individual risk factors and cumulative risk domains related to different child maltreatment groups were examined. Our results show both overlapping and unique risk factors across the domains associated with physical assault and neglect. Further, young families exposed to higher number of risk domains show higher rates for physical assault and neglect, co-occurrence of physical assault and neglect, and either form of maltreatment. In addition, various risk domains were found to be particularly important for different forms of maltreatment: family background/structure domain was found to be an important risk domain for neglect; mother-child interaction domain for both physical assault and neglect; family background/structure and maternal stressors domains for either physical assault or neglect. Closer examination of a subgroup of adolescent mothers aged 18 and below shows that family background/structure was an important risk domain for this group.     

Adolescents at risk for mistreating their children. Part II: A home- and clinic-based prevention program

OBJECTIVE: To determine if adding an intensive home visitation component to a comprehensive adolescent-oriented maternity program prevents child abuse and neglect. METHODS: We studied 171 participants in a comprehensive, adolescent-oriented maternity program who were deemed to be at high risk for child abuse and neglect. Half were randomly assigned to receive in-home parenting instruction. Major disruptions of primary care-giving by the adolescent mother were classified hierarchically as abuse, neglect, and abandonment. RESULTS: Compliance with home visits varied in relation to the support the teenage mothers received from their families and the fathers of their babies (p < .0001). There were no significant treatment group differences in the pattern of health care utilization, the rate of postpartum school return, repeat pregnancies, or child abuse and neglect. The incidence of maltreatment rose in tandem with the predicted risk status of the mother. Ultimately, 19% of the children were removed from their mother's custody. CONCLUSIONS: Prediction efforts were effective in identifying at-risk infants, but this intensive home- and clinic-based intervention did not alter the incidence of child maltreatment or maternal life course development. A parenting program that was more inclusive of the support network might be more popular with teenagers and therefore more effective. Our findings also emphasize the importance of including counseling specifically designed to prevent teenagers from abandoning their children.     

From maltreatment report to juvenile incarceration: the role of child welfare services

OBJECTIVE: This study examined whether children who received child welfare services (e.g., in-home or out-of-home placement) were more or less likely to become incarcerated as serious and violent youthful offenders than those children who were investigated as victims of abuse and neglect but received no further child welfare intervention. METHOD: Administrative data on child abuse reporting, foster care, birth records, and juvenile corrections (CYA) were linked to prospectively examine the risk of incarceration as an adolescent following an investigation of abuse or neglect after age 6. The 10 county California sample included 159,549 school-aged children reported for abuse and neglect after 1990. RESULTS: About 8 per 1,000 children in the sample were later incarcerated in CYA. African American and Hispanic children who received in-home or foster care services after the index investigation event had a lower risk of incarceration than those whose cases were closed after the investigation. Among females, the rate of incarceration was highest for those who experienced foster or group care placements. Children initially reported for neglect were more likely to be incarcerated than those reported for physical or sexual abuse. CONCLUSIONS: Public child welfare services have rarely been assessed in terms of future negative child outcomes. This study finds that one serious negative outcome, CYA involvement, can only be understood when a number of factors are considered. The importance of understanding the differences between how different subpopulations respond to services is highlighted. Specifically, our findings suggest that more attention should be focused on children who are now receiving no services after an investigated child abuse and neglect report, on females, and on victims of child neglect.     

Urbanicity matters in self-reported child maltreatment prevalence: Findings from a nationally representative study

Despite indications that there are differences in rates of child maltreatment (CM) cases in the child protection system between urban and rural areas, there are no published studies examining the differences in self-reported CM prevalence and its correlates by urbanicity. The present study aimed to: (1) identify the distribution of self-reported childhood experiences of maltreatment by urbanicity, (2) assess whether differences by urbanicity persist after adjusting for known risk factors, and (3) explore whether the associations between these risk factors and CM are modified by urban-rural designation. Using nationally representative data from waves I and III of the National Longitudinal Study of Adolescent to Adult Health, the prevalence of six maltreatment outcomes was estimated for rural, minor urban, and major urban areas (N = 14,322). Multivariable logistic models were estimated identifying if risk associated with urbanicity persisted after adjusting for other risk factors. Interactions between urbanicity and main effects were explored. Prevalence estimates of any CM, poly-victimization, supervision neglect, and physical abuse were significantly higher in major urban areas. Those from major urban areas were more likely to report any maltreatment and supervision neglect even after adjusting for child and family risk factors. The association between race/ethnicity, welfare receipt, low parental educational attainment, and disability status and CM were modified by urbanicity. Significant differences in the prevalence and correlates of CM exist between urban and rural areas. Future research and policy should use self-reported prevalence, in conjunction with official reports, to inform child maltreatment prevention and intervention.     

Predictors of justice system involvement: Maltreatment and education

Decades of research have established that experience of abuse and/or neglect in childhood is related to negative outcomes, such as juvenile delinquency. Existing research has shown that involvement in child welfare services is also related to juvenile delinquency, particularly for children who are victims of neglect. Research has also identified educational factors such as chronic absenteeism as significant predictors of involvement in the juvenile justice system. However, little research has investigated the combined influence of educational factors, child abuse, and involvement in child protective services on justice system involvement. The current study examined the influence of educational factors and involvement in child protective services on justice system involvement. The study utilized records from an educational database of children who attended a school within a county of Mississippi in any year from 2003 through 2013. Cases were then matched with records from the county Youth Court, Law Enforcement agencies, and Child Protection Services. A multivariate logistic regression controlling for gender, race, current age, and time at risk was conducted to involvement in the justice system. In general, educational factors were stronger predictors of justice system involvement than allegations of maltreatment.     

Home visiting intervention for vulnerable families with newborns: follow-up results of a randomized controlled trial

OBJECTIVE: This study aimed to: (1) Assess the community utility of a screening tool to identify families with child abuse or neglect risk factors in the immediate postnatal period (2) Determine the social validity and effectiveness of a home visiting program using community child health nurses and offering social work services for identified families, and (3) Identify factors in the immediate postnatal period associated with the child's environment that predict poor adjustment to the parenting role. METHOD: A randomized controlled trial using a cohort of 181 families was undertaken to evaluate the impact of a home visiting program. Mothers were recruited in the immediate postnatal period and allocated either into the home visiting program or into a comparison group. The research design required self-identification into the study by providing positive responses to a range of risk factors. A repeated measures design was used to test parenting stress and maternal depression from the immediate postnatal period to 12-month follow-up and physical child abuse potential to 18-month follow-up. To test whether measures taken in the immediate postnatal period were predictive for poor adjustment to the parenting role, a linear regression model was used. RESULTS: The screening procedure was shown to have utility in the context of recruitment to a research trial and mothers were willing to accept the home visiting program examined by this study from the immediate postnatal period. From as early as 6 weeks the program demonstrated ability to impact positively on maternal, infant, family, and home environment variables (testing 90 randomly allocated intervention vs. 91 comparison families). At follow-up, parental adjustment variables were not significantly different between groups (testing the remaining 68 (75.5%) intervention vs. 70 (76.9%) comparison families) and home environment assessment scores had converged. Predictive analysis of factors measured in the immediate postnatal period revealed an absence of any predictive value to demographic characteristics, which secondary prevention efforts typically target. CONCLUSIONS: Follow-up evaluation did not demonstrate a positive impact on parenting stress, parenting competence, or quality of the home environment confirming the need to test early program success on longer term outcomes. Further, thestudy not only demonstrated that there was a relationship between maternal, family and environmental factors identified in the immediate postnatal period. and adjustment to the parenting role, but also challenged demographic targeting for child abuse and neglect risk. At the same time, the immediate postnatal period presented an exciting window of opportunity to access high-risk families who may otherwise have become marginalized from traditional services.     

Risk acceptability and cost-effectiveness of protective measures against terrorist threats to built infrastructure considering multiple threat scenarios

Decisions are often needed about the need and/or extent of protective measures against explosive blast loads on built infrastructure. A decision support analysis considers fatality risks and cost-effectiveness of protective measures expressed in terms of expected cost spent on risk reduction per life saved for terrorist threats to infrastructure. The analysis is applicable to any item of infrastructure, but in this paper is applied to casualties arising from building facade glazing damage. Risks may be compared with risk acceptance criteria in the form of quantitative safety goals. The risk acceptability and cost-effectiveness of protective measures includes cost of the protective measures, attack probability,reduction in risk due to protective measures,probability of fatality conditional on successful terrorist attack and number of exposed individuals.     

Do chronic conditions increase young children's risk of being maltreated?

OBJECTIVE: To examine whether and to what extent specific chronic health conditions place young children at risk of maltreatment. METHODS: The study used a sample of Illinois children (born between January 1990 and March 1996) who were through age 3 continuously enrolled in Medicaid, a public health insurance program for low-income families. The study used "paid claims" data and ICD-9-CM health codes to identify children with one or more of three chronic conditions: chronic physical illness, developmental delay/mental retardation (dd/mr), and behavior/mental health conditions (b/mh). The analysis used Cox proportional hazard models to estimate the risk of substantiated child maltreatment that each of these health conditions confer on children under age 6. RESULTS: Among children under age 6, 24.1% had chronic physical health conditions, 6.1% had b/mh conditions, and 4.2% had dd/mr. Among the children, 11.7% were maltreated (abused or neglected). Children with b/mh conditions were 1.95 times more likely than children without such conditions to be victims of child abuse or neglect. Children with chronic physical health conditions were 1.1 time more likely to be maltreated (p相似文献   

The development of an effective response to the abuse of children in out-of-home care

The placement of children in foster or residential care does not ensure that children will be safe from abuse or neglect. The incidence of out-of-home maltreatment, especially sexual exploitation and abuse, has given rise to new community expectations and legislation which has placed the protection of children in alternate care squarely in the hands of the child protective system. These investigations differ in purpose and scope from familial investigations, and the current protective system is without adequate preparation, policy, and procedures to perform them. This paper discusses the differences in familial and out-of-home care investigations in relation to identification and reporting, assessing risk factors in the initial report, evidence gathering, essential components of the investigation, levels of culpability and corrective action approaches. The authors suggest that specialized investigation units may be more suited to these investigations than traditional child protective services.     

The assessment of risk in child abuse and neglect case investigations

Estimates vary, but statistics indicate that anywhere between one and six million children will be abused and/or neglected this year in the United States. In the process of investigating reports of abuse and neglect, child protective service workers are called upon to make numerous case decisions. Critical to much of this decision making is the assessment by the worker of the potential risk of harm that exists to the child regarding further abuse or neglect. This paper, based on two separate research studies, identifies the criteria child protective service workers use to assess this potential risk of harm to the child. The research also shows that the criteria are not used as individual factors that indicate the presence or absence of risk. Instead the criteria form a constellation of factors that function for the worker in assessing the degree of potential risk to the child. The article concludes with a discussion of the implications of research findings for child welfare practice.     

Predicting child maltreatment recurrences during treatment.

The primary purpose of the child protective services system is to protect children from the recurrence of child maltreatment. Understanding more about what predicts recurrence may help us more adequately target interventions to reduce the risk of future maltreatment. OBJECTIVE: The specific objective of this study was to identify correlates of recurrence during CPS intervention for families who were provided continuing intervention following a confirmed index report of physical abuse or neglect. METHOD: This nonconcurrent prospective study selected 446 subject families who met study eligibility requirements from 1,181 families randomly selected from the 2,902 families who had experienced a substantiated report of child abuse or neglect during the sampling year. Data were collected and coded from archival sources for 5 years following the index report. Each record was coded by two research analysts to increase inter-rater reliability. Data were analyzed with survival analysis methods: (1) Kaplan Meier and (2) the Cox Proportional Regression Model. RESULTS: Predictors of recurrence were child vulnerability, family stress, partner abuse, social support deficits, and an interaction between family stress and social support deficits. CONCLUSIONS: Implications of this and earlier research suggest that increasing social supports may help families cope with life events that increase stress and the risk of continued child maltreatment; that collaborations between CPS and domestic violence agencies are needed; and that screening maltreated children for mental health problems and other disabilities and assuring that children with these needs and their families get effective treatment may reduce the likelihood of continued maltreatment.     

Environmental and individual attributes associated with child maltreatment resulting in hospitalization or death

Maltreatment continues to be a leading cause of death for young children. Researchers are beginning to uncover which neighborhood attributes may be associated with maltreatment outcomes. However, few studies have been able to explore these influences while controlling for individual family attributes, and none have been able to parse out the most severe outcomes—injuries resulting in hospitalization or death. This study utilizes a retrospective, case-control design on a dataset containing both individual and environmental level attributes of children who have been hospitalized or died due to maltreatment to explore the relative influence of attributes inside and outside the household walls. Binary conditional logistic regression was used to model the outcome as a function of the individual and environmental level predictors. Separate analyses also separated the outcome by manner of maltreatment: abuse or neglect. Finally, a sub-analysis included protective predictors representing access to supportive resources. Findings indicate that neighborhood attributes were similar for both cases and controls, except in the neglect only model, wherein impoverishment was associated with higher odds of serious maltreatment. Dense housing increased risk in all models except the neglect only model. In a sub-analysis, distance to Family Resource Centers was inversely related to serious maltreatment. In all models, variables representing more extreme intervention and/or removal of the victim and/or perpetrator from the home (foster care or criminal court involvement) were negatively associated with the risk of becoming a case. Medi-Cal insurance eligibility of a child was also negatively associated with becoming a case. Government interventions may be playing a critical role in child protection. More research is needed to ascertain how these interventions assert their influence.     

Childhood adversity and behavioral health outcomes for youth: An investigation using state administrative data

This study aimed to measure the relative contribution of adverse experiences to adolescent behavioral health problems using administrative data. Specifically, we sought to understand the predictive value of adverse experiences on the presence of mental health and substance abuse problems for youth receiving publicly funded social and health services. Medicaid claims and other service records were analyzed for 125,123 youth age 12–17 and their biological parents. Measures from administrative records reflected presence of parental domestic violence, mental illness, substance abuse, criminal justice involvement, child abuse and/or neglect, homelessness, and death of a biological parent. Mental health and substance abuse status of adolescents were analyzed as functions of adverse experiences and other youth characteristics using logistic regression. In multivariate analyses, all predictors except parental domestic violence were statistically significant for substance abuse; parental death, parental mental illness, child abuse or neglect and homelessness were statistically significant for mental illness. Odds ratios for child abuse/neglect were particularly high in both models. The ability to identify risks during childhood using administrative data suggests the potential to target prevention and early intervention efforts for children with specific family risk factors who are at increased risk for developing behavioral health problems during adolescence. This study illustrates the utility of administrative data in understanding adverse experiences on children and the advantages and disadvantages of this approach.     

Promoting the development of resilient academic functioning in maltreated children

This study examined (a) the extent of heterogeneity in the patterns of developmental trajectories of language development and academic functioning in children who have experienced maltreatment, (b) how maltreatment type (i.e., neglect or physical abuse) and timing of abuse explained variation in developmental trajectories, and (c) the extent to which individual protective factors (i.e., preschool attendance, prosocial skills), relationship protective factors (i.e., parental warmth, absence of past-year depressive episode, cognitive/verbal responsiveness) and community protective factors (i.e., neighborhood safety) promoted the development of resilient language/academic functioning trajectories. Longitudinal data analyses were conducted using cohort sequential Growth Mixture Model (CS-GMM) with a United States national representative sample of children reported to Child Protective Services (n = 1,776). Five distinct developmental trajectories from birth to age 10 were identified including two resilient groups. Children who were neglected during infancy/toddlerhood or physically abused during preschool age were more likely to be in the poorer language/academic functioning groups (decreasing/recovery/decreasing and high decreasing) than the resilient high stable group. Child prosocial skills, caregiver warmth, and caregiver cognitive stimulation significantly predicted membership in the two resilient academic functioning groups (low increasing and high stable), after controlling for demographics and child physical abuse and neglect. Results suggest that it is possible for a maltreated child to successfully achieve competent academic functioning, despite the early adversity, and identifies three possible avenues of intervention points. This study also makes a significant contribution to the field of child development research through the novel use of CS-GMM, which has implications for future longitudinal data collection methodology.